The commoner diseases of the eye : how to detect and how to treat them . y inspecting the superficialstructure and parts surrounding that patient is to be seated in a chair facing awindow through which a good illumination canbe obtained. The lids are to be examined for any irregu-larity in their outline, for distended vessels,edema, thickening, redness or tumors (such ascysts) of the Meibomian glands (Chalazia) —and for scales, crusts or ulcerations along theirmargins (blepharitis). It should be noted ifthey are in close apposition to the eyeball, andwhether their margins turn out (e
The commoner diseases of the eye : how to detect and how to treat them . y inspecting the superficialstructure and parts surrounding that patient is to be seated in a chair facing awindow through which a good illumination canbe obtained. The lids are to be examined for any irregu-larity in their outline, for distended vessels,edema, thickening, redness or tumors (such ascysts) of the Meibomian glands (Chalazia) —and for scales, crusts or ulcerations along theirmargins (blepharitis). It should be noted ifthey are in close apposition to the eyeball, andwhether their margins turn out (ectropion), orturn in (entropion), or if there is inability toclose the lids (lagophthahnus), or drooping ofthe upper lid (ptosis). The cilia or eyelashes should next be in-spected to see if any are misplaced, or if theycurve inward (trichiasis). The position andpermeability of the puncta should be ascer-tained. Pressure should be made over the METHODICAL EXAMINATION OF THE EYE 25 lachrymal sac in the endeavor to squeeze outthrough the puncta any fluid (mucus or pus). Everting the Lower Lid. that may be retained therein. It should be notedif the conjunctival sac contain any secretion, 26 COMMONER DISEASES OF THE EYE and if so whether it is mucous or purulent;whether the tears accumulate in the corner ofthe eye, overflow and run down over the cheeks(epiphora). For a thorough examination of the mucouslining of the lids and eyeball (conjunctiva),the former should be (.verted and their innersurfaces inspected for any undue redness,roughness or other abnormality. The lower lid is everted by placing the tipof the thumb upon the skin near its margin anddrawing it downward, at the same time pressingbackward, and telling the patient to roll theeyeball upward. The eversion of the upper lid is somewhatmore difficult, and is accomplished in the fol-lowing manner. The patient is told to lookdozen during the whole time required for evert-ing the lid. The surgeon stands behind theoperating c
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